Risk Factors Analysis Of Unplanned Readmission In Patients With Chronic Heart Failure

Objective: To find the risk factors affecting unplanned readmission of patients with chronic heart failure,construct and validate the risk model of unplanned readmission,aim to early identify and screen patients at high risk of chronic heart failure readmission,and provide reference for the implementation of purposeful clinical intervention.Methods:According to the inclusion and exclusion criteria,584 patients who were hospitalized in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University and diagnosed with chronic heart failure from January 2019 to January2020 were collected and divided into readmission group(167 patients)and non-readmission group(417 patients).Risk factors for unplanned readmission were selected by univariate analysis and multivariate logistic regression analysis,and statistically significant(P <0.05)risk factors were included in the regression model.The constructed risk prediction model is internally verified by bootstrap to test the feasibility of the model.The actual capability of the model was evaluated using the goodness of fit Hosmer-Lemeshow(H-L)and the area under the receiver operating characteristic(Receiver Operating Characteristic Curve,ROC)curve(Area Under Curve,AUC).Results:(1)Among 584 patients with chronic heart failure,167 unplanned readmissions(28.60%);(2)After univariate and multivariate analysis,five risk factors were included:NYHA cardiac function grade,combined atrial fibrillation,no β-blocker,red blood cell distribution width,and NT-proBNP.(3)The C-statistic of the prediction model is0.719(95%CI:0.673-0.764).The P-value of the consistency H-L test was 0.921,suggesting that there was no significant difference between the prediction and the true value.The decision curve(Decision Curve Analysis,DCA)indicates that the nomogram of this study can be used as a useful tool for clinical diagnosis.Conclusion: NYHA cardiac function grade,combined with atrial fibrillation,not taking β-blocker,red blood cell distribution width,and NT-proBNP are independent risk factors for unplanned readmission of patients with chronic heart failure.This model is better predictive,and can provide reference for the treatment and management of chronic heart failure.